DESCRIPTION: (Applicant's Abstract) The long-term effects of prenatal tobacco, marijuana, and alcohol exposure on the offspring of adolescents have not previously been studied. These substances are prevalent among pregnant teenagers and their adverse effects on the offspring of adult users have been documented. Given the higher risks associated with teenage pregnancy, it is important to study the effects of these teratogens in this vulnerable population. Aim # 1) Examine the long-term effects of prenatal tobacco and marijuana exposure on the growth, morphology, cognitive and behavioral characteristics of six-year-old offspring of adolescent mothers. The analyses will consider the direct effects of prenatal tobacco and marijuana exposure and environmental factors as potential mediators and moderators of those effects. The analyses will also consider the effects of factors that are associated with adolescent parenthood which may create a sub-optimal developmental context for the offspring and describe the impact of these variables on the relationship between prenatal tobacco or marijuana exposure and outcome.* Aim # 2) Describe patterns of tobacco and marijuana use in the postpartum years among adolescents' and compare those patterns to those of the adolescents' substance use before and during pregnancy. Examine the relationship between the teenage mother's substance use, psychological status, coping skills, and socioeconomic characteristics. Aim # 3) Compare effects of prenatal tobacco and marijuana exposure on offspring of adolescent mothers with the effects on same-aged offspring from a recent sample of adult mothers who attended the same prenatal clinic. We hypothesize that there will be more negative growth, cognitive, and behavioral outcomes among offspring of adolescent mothers, as compared to adult mothers, that can be explained by the unique aspects of adolescent parenthood. Our study will utilize the subject population gathered from a study of pregnant adolescents and their offspring. This study examined patterns of substance use before and during pregnancy and the effect of prenatal substance exposure on the offspring of adolescents. A major strength of the ongoing study is that it is the only study that has systematically measured the licit and illicit drug use of teenage girls before and during pregnancy. It is also the only study that has carefully measured growth, morphology and behavior of the newborns of teenage mothers. A further strength of the study is our exceptional follow-up rate. We are currently in touch with 97.6% of the sample.